**1. Introduction**

Globally, there is an increase in the prevalence of non-communicable diseases such as Type 2 Diabetes Mellitus, cancer, hypertension, other cardiovascular diseases and stroke. Most of these illnesses are related to a modification in the lifestyle worldwide costs of healthcare leading to morbidity and mortality are diseases linked to environmental factors and lifestyle modification [1]. There has been a steady increase worldwide in the prevalence of non-communicable diseases to an alarming rate including diabetes mellitus which is becoming an epidemic [2–4] as this increase has been on for the past 20 years [5–7]. According to the International Diabetes Federation (IDF), it is estimated that 387 million adults are diabetic with either type 1 or type 2 diabetes mellitus [3] and this number is predicted to rise to 392 million by 2035 [3, 8]. This predicted increase is due to globalization and urbanization [2]. Urbanization is affected by modifications in lifestyle with physical inactivity and sedentary lifestyle from various epidemiological and interventional studies have revealed that the majority of chronic illnesses such as diseases that affect the cardiovascular system such as hypertension, cancer and Type 2 Diabetes Mellitus result due to lifestyle behavior and habits that are caused by improper eating habits, eating unhealthy foods, and lack of physical activity [9–11]. In primary and specialist health facilities, the majority of the consultations are related to highly preventable lifestyle.

Lifestyle modification is the first line of treatment in the management of noncommunicable diseases [12, 13]. The commonest form of diabetes mellitus affecting 90% of diabetics is Type 2 Diabetes Mellitus. Diabetes mellitus is an economic and health burden to the sufferer and health systems as it also affects the quality of life especially when complications occur [2, 4, 8, 9, 14].

Diabetes mellitus is a risk factor for cardiovascular disease, a common cause of blindness due to diabetic retinopathy, amputation of the lower limb following diabetic neuropathy and diabetic foot ulcer and other life-threatening complications such as end-stage kidney disease (ESKD) [9, 15, 16]. Globally, diabetes mellitus is the second leading cause of blindness and renal disease [17]. Therefore it is important to prevent diabetes mellitus as it causes loss of working hours due to the impact they have on the economy and the individual. This is worst in the low and middle-income countries with the poor healthcare system and lack of health insurance for the entire populace where people have to pay out of pocket when seeking healthcare.

Diabetes mellitus is a chronic non-communicable metabolic disease in which the plasma glucose is elevated [12], characterized by insulin resistance and deficiency in insulin secretion and it may be acquired or hereditary [17, 18]. Obesity and overweight are risk factors for diabetes mellitus [17]. This is because insulin resistance and metabolic syndrome are promoted by obesity and overweight [8, 17]. For the primary prevention of diabetes mellitus, a 5-10 kg weight loss is recommended [6, 8].

Sensitivity to insulin and glycaemic control is improved by engaging in moderate weight loss and increased physical activity [6]. Obesity is a risk factor for diabetes mellitus [6]. Ignoring lifestyle medicine leads to an increased workload on the healthcare system. Globalization and adaptation of the Western lifestyle are some of the reasons for the increasing numbers of chronic diseases including Type 2 Diabetes Mellitus. Making good choices in lifestyle can significantly help in lowering the risk of these chronic diseases as most of the risk factors for these diseases are related to lifestyle behavior [2].

The history of lifestyle is very important in history taking [7]. The component of lifestyle medicine which promotes weight loss and prevents obesity is essential in the management and prevention of diabetes mellitus [8, 19, 20]. Therefore diabetes mellitus can be prevented by maintaining an ideal weight, therefore, modification in lifestyle does not only prevent diabetes mellitus but also prevents other noncommunicable diseases [3, 8, 21].

#### **2. Research methodology**

This is review article on the role of lifestyle medicine in the management of Type 2 Diabetes Mellitus. A search was done using Google scholar, and PubMed using the key words lifestyle medicine and diabetes, the role of the pillars of lifestyle and management of Type 2 Diabetes Mellitus. Articles that highlighted the management of Type 2 Diabetes Mellitus using hypoglycaemic agents were excluded in this study.

#### **3. What is lifestyle medicine**

Lifestyle medicine is a relatively new medical specialty yet to be established in most countries. Lifestyle medicine has been defined by various scholars. Lifestyle medicine is the use of interventions and integration of lifestyle practices within conventional medicine to lower the risk of disease. It serves as an adjunct to the

**311**

*The Role of Lifestyle Medicine in the Management of Diabetes Mellitus*

management of illnesses [22, 23]. The practice of lifestyle medicine is evidencebased in scientific research and it addresses the root and underlying causes of diseases by empowering individuals with life skills and knowledge through a behavioral change in making healthy choices [24]. In this new medical discipline, it uses daily habits and practice impacts on both the prevention and treatment of diseases to improve the overall health of the individual in conjunction with both pharmaceutical and surgical therapy [3, 25]. All pharmaceutical agents have side effects as most drugs are metabolized in the liver and excreted by the kidneys. Hence it is very important to prevent them like diabetes mellitus. The Canadian Academy of Lifestyle Medicine defines lifestyle medicine as an evidence-based branch of medicine in which there is a comprehensive change in lifestyle including nutrition, physical activity, stress management, social connectedness and exposure to harmful environmental factors [26]. Lifestyle medicine is used to prevent and treat lifestylerelated diseases but it does not tell patients to abandon and stop their medications. Lifestyle-related diseases (LRD) are illnesses in which lifestyle factors significantly influence the pathophysiology of the disease as there can be a significant improvement in the prevention and treatment of the disease following a change in the aetiological factors. Travel medicine and sports medicine, lifestyle medicine is a novel branch in the clinical practice of medicine [8] but it is gaining grounds due to its benefits. The prevention and reversal of chronic diseases linked to lifestyle can be done using evidence-based lifestyle therapeutic approaches. Lifestyle interventions affect physical and mental health positively, including a better quality of life [13]. The focus of lifestyle medicine programmes in the management of diabetes mellitus is to change the eating habits and physical activity behavior, especially in obese patients with type 2 diabetes mellitus is very important to control symptoms and it reduces the risk of cardiovascular-related morbidity and diabetic complications [27].

The components of lifestyle medicine are interventions that when they are practised lead to improvement in health and overall wellbeing. The modalities of

3.Healthy eating by promoting consumption of whole plant-based diet.

6.Increased mental and emotional wellbeing by having good social

**5. The role of lifestyle medicine in the management of diabetes mellitus**

All the components of lifestyle medicine are important and play necessary roles in the prevention of Type 2 Diabetes Mellitus and management of Type 1 & 2 Diabetes Mellitus. This is because Type 1 Diabetes Mellitus has a strong

*DOI: http://dx.doi.org/10.5772/intechopen.99555*

**4. The pillars of lifestyle medicine**

lifestyle medicine are (**Figure 1**) [3, 13, 28]:

2.Stress management.

connectedness.

1.Increased physical activity and exercise.

4.Adequate sleep and good sleep hygiene.

5.Avoid consumption of tobacco and alcohol.

#### *The Role of Lifestyle Medicine in the Management of Diabetes Mellitus DOI: http://dx.doi.org/10.5772/intechopen.99555*

*Type 2 Diabetes - From Pathophysiology to Cyber Systems*

especially when complications occur [2, 4, 8, 9, 14].

seeking healthcare.

related to lifestyle behavior [2].

communicable diseases [3, 8, 21].

**2. Research methodology**

excluded in this study.

**3. What is lifestyle medicine**

Lifestyle modification is the first line of treatment in the management of noncommunicable diseases [12, 13]. The commonest form of diabetes mellitus affecting 90% of diabetics is Type 2 Diabetes Mellitus. Diabetes mellitus is an economic and health burden to the sufferer and health systems as it also affects the quality of life

Diabetes mellitus is a risk factor for cardiovascular disease, a common cause of blindness due to diabetic retinopathy, amputation of the lower limb following diabetic neuropathy and diabetic foot ulcer and other life-threatening complications such as end-stage kidney disease (ESKD) [9, 15, 16]. Globally, diabetes mellitus is the second leading cause of blindness and renal disease [17]. Therefore it is important to prevent diabetes mellitus as it causes loss of working hours due to the impact they have on the economy and the individual. This is worst in the low and middle-income countries with the poor healthcare system and lack of health insurance for the entire populace where people have to pay out of pocket when

Diabetes mellitus is a chronic non-communicable metabolic disease in which the plasma glucose is elevated [12], characterized by insulin resistance and deficiency in insulin secretion and it may be acquired or hereditary [17, 18]. Obesity and overweight are risk factors for diabetes mellitus [17]. This is because insulin resistance and metabolic syndrome are promoted by obesity and overweight [8, 17]. For the primary prevention of diabetes mellitus, a 5-10 kg weight loss is recommended [6, 8]. Sensitivity to insulin and glycaemic control is improved by engaging in moderate weight loss and increased physical activity [6]. Obesity is a risk factor for diabetes mellitus [6]. Ignoring lifestyle medicine leads to an increased workload on the healthcare system. Globalization and adaptation of the Western lifestyle are some of the reasons for the increasing numbers of chronic diseases including Type 2 Diabetes Mellitus. Making good choices in lifestyle can significantly help in lowering the risk of these chronic diseases as most of the risk factors for these diseases are

The history of lifestyle is very important in history taking [7]. The component of lifestyle medicine which promotes weight loss and prevents obesity is essential in the management and prevention of diabetes mellitus [8, 19, 20]. Therefore diabetes mellitus can be prevented by maintaining an ideal weight, therefore, modification in lifestyle does not only prevent diabetes mellitus but also prevents other non-

This is review article on the role of lifestyle medicine in the management of Type 2 Diabetes Mellitus. A search was done using Google scholar, and PubMed using the key words lifestyle medicine and diabetes, the role of the pillars of lifestyle and management of Type 2 Diabetes Mellitus. Articles that highlighted the management of Type 2 Diabetes Mellitus using hypoglycaemic agents were

Lifestyle medicine is a relatively new medical specialty yet to be established in most countries. Lifestyle medicine has been defined by various scholars. Lifestyle medicine is the use of interventions and integration of lifestyle practices within conventional medicine to lower the risk of disease. It serves as an adjunct to the

**310**

management of illnesses [22, 23]. The practice of lifestyle medicine is evidencebased in scientific research and it addresses the root and underlying causes of diseases by empowering individuals with life skills and knowledge through a behavioral change in making healthy choices [24]. In this new medical discipline, it uses daily habits and practice impacts on both the prevention and treatment of diseases to improve the overall health of the individual in conjunction with both pharmaceutical and surgical therapy [3, 25]. All pharmaceutical agents have side effects as most drugs are metabolized in the liver and excreted by the kidneys. Hence it is very important to prevent them like diabetes mellitus. The Canadian Academy of Lifestyle Medicine defines lifestyle medicine as an evidence-based branch of medicine in which there is a comprehensive change in lifestyle including nutrition, physical activity, stress management, social connectedness and exposure to harmful environmental factors [26]. Lifestyle medicine is used to prevent and treat lifestylerelated diseases but it does not tell patients to abandon and stop their medications.

Lifestyle-related diseases (LRD) are illnesses in which lifestyle factors significantly influence the pathophysiology of the disease as there can be a significant improvement in the prevention and treatment of the disease following a change in the aetiological factors. Travel medicine and sports medicine, lifestyle medicine is a novel branch in the clinical practice of medicine [8] but it is gaining grounds due to its benefits. The prevention and reversal of chronic diseases linked to lifestyle can be done using evidence-based lifestyle therapeutic approaches. Lifestyle interventions affect physical and mental health positively, including a better quality of life [13]. The focus of lifestyle medicine programmes in the management of diabetes mellitus is to change the eating habits and physical activity behavior, especially in obese patients with type 2 diabetes mellitus is very important to control symptoms and it reduces the risk of cardiovascular-related morbidity and diabetic complications [27].
